BASILIOS C COSTARAS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****70

License Status

NOT RENEWED

Business

First Name

BASILIOS

Middle

Last Name

COSTARAS

Suffix

DDS

Business Name

BASILIOS C COSTARAS DDS

Original Issue Date

01/07/2008

Effective Date

12/01/2015

Expiration Date

09/30/2018

City

DUNLAP

State

Zip

61525

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018